In-office parent training improved disruptive child behavior

Ten-week parent training at a primary care pediatric office improved parenting practices and children’s disruptive behaviors, according to researchers in Massachusetts.

Parents of children aged 2 to 4 years (n=150) were randomly assigned to a 10-week Incredible Years parent-training group (n=89) or a waiting list, and an additional 123 parents received training without a randomly selected comparison group. All parents reported disruptive behavior from their children. Parent and child behavior was measured by self-reports (30-item Parenting Scale for negative discipline styles and the 36-item Early Childhood Behavior Inventory for presence and intensity of child disruptive behaviors) and videotaped observations prior to the intervention, as well as immediately after and 12 months after the intervention.

According to researchers, the Incredible Years program "encourages proactive, nurturing parenting, while discouraging harsh, punitive approaches using videotaped modeling, group discussion, role plays and home practice tasks arranged across four modules (play, praise and rewards, effective limit setting and handling misbehavior)," researchers wrote.

The program was co-led by a researcher and pediatric staff member.

Both intervention groups had lower self-reported negative parenting behavior at all follow-up points compared with baseline; however, there was no change among parents in the waiting list group. Similarly, Early Childhood Behavior Inventory problem and intensity scales were lower at follow-up in the intervention groups compared with baseline. At 6 months, however, the intensity score was lower than baseline in the group randomly assigned to the intervention (P=.049).

Parent-report scale scores were higher at all follow-up points for both intervention groups compared with the waiting list group (P<.05).

In an accompanying editorial, Martin T. Stein, MD, of the division of general academic pediatrics, child development and community health at the University of California, San Diego School of Medicine, said the efficacy of group-based parent training for disruptive child behavior has been established, but the current study demonstrates how the intervention can be applied in an office setting.

"The time is right for primary care pediatricians to bring behavior modification methods into the treatment plan for young children with disruptive behaviors," Stein wrote. "The study by Perrin et al is a good start in showing the way to accomplish this goal."

For more information:

Perrin EC. JAMA Pediatr. 2013;doi:10.1001/jamapediatrics.2013.2919.

Stein MT. JAMA Pediatr. 2013;doi:10.1001/jamapediatrics.2013.3647.

Disclosure: The researchers report no relevant financial disclosures.